HC Deb 15 August 1913 vol 56 cc3256-67

"So much of Sub-sections (9) and (10) of Section 81 and of Part II. of the Second Schedule of the principal Act as excludes insured persons in Ireland from medical benefit and fixes the contributions payable by such insured persons shall cease to have effect and such other provisions in the principal Act as relate to the payment of contributions and the provision of medical benefit shall apply to insured persons in Ireland."

Clause brought up, and read the first time.

Mr. O'GRADY

I beg to move, "That the Clause be read a second time."

This Amendment asks the Committee to insert in the Act a provision which would bring Ireland within the scope of medical benefit. Members of the Committee will know that when this Act was being discussed in the House Ireland was exempted from the provisions of medical benefit on the ground that it had already a State medical service. That medical service, as I understand, is under the Poor Law with the taint of pauperism attaching to it. It works very well so far as the rural areas are concerned. I am quite aware that if we were to ask that Ireland, as a whole, should be placed under the Act for medical benefit, purposes it would involve an increase of the contributions of employers and workmen, particularly in the rural areas, and to that extent it would work very harshly in the case of people in receipt of very low wages; but the point has been brought to our attention by people in the large industrial areas of Ireland, particularly in the trade unions of Ireland, who feel very much the fact that they were cut out of the Act, and who have deputised my hon. Friends and myself to try and get them brought within the scope of the Act. They would, of course, be prepared to pay the extra cost involved. I know that this is a very thorny subject. I understand that a Committee was appointed by the Government to consider the matter, and they have come to a conclusion as to the way out of the difficulty without involving the whole of Ireland within the scope of the Act. It seems to me as an outsider pure and simple, and speaking only for the trade unionists, that it might be possible to meet the difficulty by including the six county borough areas of Ireland. That would embrace the great industrial centres like Belfast, Dublin, Cork, and Waterford, with certain areas outside, and I think that my hon. Friends and myself would be prepared to accept a compromise of that character. I beg to move the new Clause, however, for the purposes of discussion, and I hope that subsequently we shall arrive at a compromise on the lines I have suggested, and that the Amendment will be considered in that light.

Mr. MASTERMAN

I wish that my hon. Friend would not advance things for the purposes of discussion in this Committee, if, as I think he knows, they are impracticable in connection with the present situation. I have no wish to give any opinion as to whether medical treatment ought to be extended to Ireland or to any part of Ireland, because that is not the consideration I put before the Committee. A very important Departmental Committee was appointed to go into the whole question of medical benefit in Ireland, and the Chancellor of the Exchequer in the House of Commons gave a pledge that no alteration should be made in the present law until not only the Committee had reported but the Report and the evidence had been in the hands of Members of the House of Commons for some appreciable time in order that they might be able to make up their minds on the matter. In these circumstances, it is quite impossible for me to go behind the pledge he made to the House of Commons, and I would submit that it would be better that the Committee should not spend much time on the discussion of this Amendment. If, as the result of the Report of the Committee and the reading of the evidence during the Recess, there is any general agreement that medical benefit ought to be extended either to Ireland or to any part of Ireland, I can assure the Committee that the Government will have no reluctance in bringing in legislation to that effect. Under those circumstances, I would urge that we should not go into any general discussion now as to Ireland and medical benefit.

Mr. FORSTER

Can the right hon. Gentleman tell us something about the proceedings of the Committee to which he has referred? I know that some months ago they went to Ireland, and carried out investigations there, but surely their Report is considerably overdue. I forget how many months it is since they began their work, or since they visited Ireland, but really I should have thought that they would have had time to put their proposals into shape, seeing that they have not been taking evidence in Ireland for a very considerable time. I never liked the removal of Ireland from the general scope of the Insurance Bill while it was a Bill. I always thought that it would have been very much better if the whole scope of the provisions of the Bill had applied to Ireland. I think that the hon. Gentleman opposite has done good service in bringing this matter forward, and if he goes to a Division, I shall vote with him.

Mr. DEVLIN

I am very sorry that the right hon. Gentleman who has charge of this Bill has not seen his way to accept the proposal which has been made by my hon. Friend opposite (Mr. O'Grady). I should just like to say that I do not think the statement of the hon. Member for Sevenoaks (Mr. Forster) in regard to the Committee which was recently appointed was altogether justifiable. As far as I know, up to the present, the only charge that has been made against that Committee has been a charge that it was rushing its business.

Mr. FORSTER

I never made any charge of rushing against the Committee.

Mr. DEVLIN

No, the right hon. Gentleman made here precisely the opposite charge from that made in the House of Commons, namely, that we were not giving that placid and careful attention to all these proposals which is given, say, in a Committee of this character. In my opinion, there never was a Committee which did its work with more promptitude or with a greater desire to gather general knowledge for the solution of a problem. The right hon. Gentleman does not seem to be aware of the fact, but the Committee sent in their Report over a fortnight ago.

Mr. WORTHINGTON-EVANS

Where is it?

Mr. DEVLIN

I do not know. It passed out of my hands when I signed it. I do not carry it about with me. All I know is that the Committee took evidence in all the great centres in Ireland, and the evidence was practically unanimously in favour of the application of medical benefits to the six county boroughs in Ireland. Evidence was taken from employers, from employed, from insured persons, from representatives of the various societies, from trade union bodies and from friendly organisations, and they were absolutely united in their demands for the application of medical benefit to the county boroughs. We were anxious to take evidence also in the agricultural parts of the country, but that would have been a gigantic task which would have occupied far more time than could possibly be given to it, and so completely did we feel the urgency of the problem as it affects the county boroughs, that our Report was not one dealing absolutely with the whole question, but with that part of Ireland which was clamorous in its demands for the application of medical benefit. Therefore, when my hon. Friend put down his Amendment, I thought that it might have been accepted by the Government.

I understand that the right hon. Gentleman is bound by the promise given by the Chancellor of the Exchequer in the House of Commons, and I should be very sorry to ask him to depart from that promise, but in view of the fact that the Opposition are so anxious to have the medical benefit applied to these six county boroughs, and that there is an opportunity, through this Bill, when it comes up on Report, to include the changed Amendment of my hon. Friend, I would ask the right hon. Gentleman to make such representations to the Chancellor of the Exchequer as would enable him to take this part of the Report which recommends medical benefit, and have it put into the Bill, so that it could be accepted by the universal consent of all parties. I may say that at present Ireland is being robbed of £500,000 in connection with this matter. We are entitled to have 5s. for each insured person. That amounts to £100,000, and we have only received £50,000. We want this money for medical benefit. The cities of Belfast, Dublin, Cork and Waterford are clamouring for medical benefit, and I think that the Government ought to concede it. They have in rural Ireland a service of their own, with which I am by no means satisfied, and I would like to see it abolished altogether. It is a service which the people regard as putting upon them an indignity if they have to take advantage of it, but since the people are not pressing for the medical benefit, and seeing that we do not want to do anything against the will of the people, and that we only want it in those parts of Ireland which have demanded it, and pressed for it, I think that the right hon. Gentleman ought to concede our demands.

Mr. MASTERMAN

I cannot really interpret, unless I have some authority to do so, statements made by hon. Gentlemen opposite as releasing the Chancellor of the Exchequer from a pledge given to the whole House of Commons. I should be surprised if in this case they have even a right to speak for their party. I certainly could not accept the Amendment, and I must appeal to hon. Gentlemen to maintain that pledge. I learn that the Majority Report of the Committee was only received last Friday, and that the last of the various Minority's Notes was only received yesterday. It was, therefore, quite impossible for us to get the Report out before. The fact that there are Minority Notes shows that the solution of the question is by no means as simple as some hon. Members might think. I am quite sure that the only sane and reasonable course is to adopt the course the Chancellor of the Exchequer indicated, and to allow Members of the whole House and persons in Ireland to see the whole Report and the evidence on which the Report is based, and then, if necessary, to legislate separately next session.

Mr. HARRY LAWSON

The hon. Member for West Belfast (Mr. Devlin) has made a most important speech, and I think that my hon. Friends on this side of the Committee ought to take note of it. I, for one, am perfectly prepared to accept his assurance that the Committee were unanimously in favour of extending medical benefit to county boroughs in Ireland.

Mr. DEVLIN

What. I stated was that the evidence from all sources was in favour of the medical benefit. I did not say the. Report was in favour of it.

Mr. HARRY LAWSON

But the Report was strongly in favour of it. That being so, and, looking at the opinions we entertained last year, I am bound to say that I see no reason for rejecting this Amendment now. It is all very well to say we shall have another Amending Bill which may be passed next year or may not. Next year there will be great pressure of legislation and a good deal of noise downstairs, and no Amending Bill may come before the House at all. If it is true that the evidence is overwhelmingly in favour of this change, then I think, looking at the unanimity of the Irish members of the Committee on this point, the hon. Gentleman opposite would be well advised to press his Amendment to a Division before the Report stage. The evidence will have been published by the time of the Report stage, and if there is any reason for removing the Amendment it can be done then or in the House of Lords. Under these circumstances I think we ought to vote upon the Clause.

Mr. G. H. ROBERTS

I want to say that we did not regard this proposal as impracticable when we placed it on the Paper, nor did we put it down simply for the purpose of wasting the time of the Committee through the discussion that would ensue upon it. Very strong representations have been made to us by the organised labour bodies in Ireland. Of course, we are always fearful as to the extent to which these bodies may make representations, and, therefore, we are particularly glad now to be reinforced by the statement which has just been made by the hon. Member for West Belfast, which shows that there is a very strong and widespread demand for the extension of this benefit to Ireland. We always felt that it was a flaw in the original Act; nevertheless, in the absence of sufficient evidence we did not feel it was competent for us to take decisive action then upon the floor of the House. However, after we had been in touch with the various representative bodies in Ireland, and had heard their representations, we decided to place this new Clause on the Paper. I do not want to endeavour to force the right hon. Gentleman to break a pledge that has been given to the House. That is not the purpose of my hon Friends or myself. As I understand it, the Committee's Report may be published in the course of a few days; then we shall be in a position to judge the extent to which this benefit can practically be applied to Ireland. I apprehend that there are some difficulties respecting the agricultural parts of Ireland. I am certainly not in a position now to judge exactly how the benefit should be applied to Ireland. However, there seems to be unanimity as to the desirability of its being extended to certain large boroughs which, in my opinion, should include industrial areas. I think we shall serve our purpose best if we ask leave to withdraw now for the purpose of further considering the matter after this Report has been issued, and with a view to dealing with it upon the Report stage. We will then be in a position to decide the exact terms upon which we can submit the question for decision. Therefore,. I beg leave to withdraw for the purpose I have stated.

Mr. O'GRADY

I cannot help commenting upon the right hon. Gentleman's statement. I want to say that, in moving this Amendment, and in suggesting an alteration of the Clause itself, I thought the matter was one for consideration and discussion. I will not, however, press my Amendment now. In view of what has been stated by the hon. Gentleman the Member for West Belfast, we will reserve our right to put this question down upon the. Report stage. I therefore beg leave to withdraw.

Mr. STEPHEN GWYNN

Before we pass from this, I think we might ask the right hon. Gentleman the Financial Secretary to the Treasury to give an undertaking that the Government will not close their mind to the possibility of dealing with this matter on the Report stage after the Report of the. Committee has been laid before the House. May we take it from him that we are not now getting a final answer, and that this matter be dealt with in the present year?

Mr. MASTERMAN

I cannot say, of course, how far such an Amendment would be in order on the Report. If it lays an extra charge, I doubt whether it would be in order. Anyhow, I do not think that the pledge which was given to the House, and which was given in response to an appeal from hon. Gentlemen on that side, could be broken by the Chancellor of the Exchequer. I will make certain representations to him. I think it would be a mad course for the Committee at this moment, without having seen the Report—an absolutely irresponsible course, quite apart from the pledge to the right hon. Gentlemen—to try now and decide this, which involves perhaps twenty or thirty consequential Amendments, and gives a general extension of medical benefit to Ireland. That certainly ought not to be done on a stage like this of a Bill. I very earnestly hope that the Irish Members themselves may see their way to accept the withdrawal of the hon. Gentleman, guaranteeing, as I do, that if, during the Recess, I find there is a general feeling to give this benefit on the lines indicated by the hon. Gentleman the Member for West Belfast, we will next year legislate on the subject.

Mr. WORTHINGTON-EVANS

The Committee has just heard from the right hon. Gentleman the Financial Secretary to the Treasury that unless the Committee puts this in now it will not be competent to put it in upon Report; and the best the Government can promise is that they will try during the Recess to ascertain the feeling of other people in regard to it, and some time next year, or never, bring in another Amending Bill with a view to giving medical benefit in Ireland. Sir, I hope the hon. Member who moved this, and who apparently intended sincerely to ask the opinion of the Committee upon it—although the Financial Secretary did not give him credit for that, but accused him of having moved it only for the purpose of wasting time—will not withdraw if he really was sincere in bringing it forward. After the answer of the Financial Secretary I do not see how he can possibly withdraw it now. We have had the very interesting statement that Ireland now has come round to the opinion that medical benefit ought to be extended to it; or, at all events, to the county boroughs. I will deal with the difference between the county boroughs and the agricultural districts. The hon. Member who moved this was inclined to limit it to the county boroughs, although he did not actually do so in his Amendment. But the Committee should remember that the low paid labour in agricultural districts has already had provision made for it by a large reduction in contributions, and if the total benefit which is to be given in respect of those reduced contributions is taken into account, I do not think anyone can honestly contend there is any real difference in the ability to pay the contribution between the boroughs and the country districts, if the lower contribution payable in respect of the country districts is taken into account. I do ask the hon. Member, if he was sincere in bringing forward this Clause, to stick to it, and get the opinion of the Committee upon it now. It cannot be done on Report; and if the Government is genuine in its desire to meet the wishes of the Committee it will help the Government if this Committee has expressed itself strongly in favour of the medical benefit. I, for one, have never believed that it was desirable to cut up national insurance into four so-called national sections. I have never believed that it was right to cut out Ireland from medical benefit, if it was right to include the rest of the United Kingdom. It created an enormous difficulty in connection with transfers, with the Army and Navy Fund, and in many other ways, all of which are self-created difficulties arising from treating the various parts of the country differently. I hope now that the Committee has an opportunity of expressing its opinion that it will not allow it to go by.

Mr. R. HARCOURT

I only want to deal with the practical point affecting the Division. As I understand the situation, I think leave to withdraw has been asked and refused.

The CHAIRMAN

The Question has not yet been put.

Mr. J. SAMUEL

I am really very much surprised at the speech of the hon. Member for Colchester. It is well known that when the original Bill was introduced medical benefit was given to Ireland, and at the request of the Nationalist Members it was withdrawn. It was done at their request, I think, because of the medical service in Ireland. During the discussion at the time it was understood that a Committee would be appointed to consider the whole matter. In this Amendment there is nothing about the six county boroughs. I ask the hon. Member for Mile End and also the hon. Member for Colchester are they prepared to legislate now upon the statements of one of the members of that Committee without having an opportunity of reading the Committee's Report? The right hon. Gentleman in charge of the Bill was attacked right and left this morning because he had not information to supply to the Committee. Now the hon. Member for Mile End complains that the Government are bringing in Amendments without furnishing the Committee with the necessary information. We have the hon. Member for Colchester actually asking us now to legislate upon this very important point after the Nationalist Members had asked the Government to withdraw the original provision in the Bill giving medical benefit, and also asking us to legislate without having the Report of the Committee before us.

Sir P. MAGNUS

Where is the Report?

Mr. J. SAMUEL

You have heard the right hon. Gentleman in charge of the Bill say that it was only received last Friday, and that the Minority Notes only came in yesterday. I think it is most unfair to us members of the Committee to decide an important point like this under such circumstances. If Ireland is agreed, we are all in favour of giving her medical benefit. There is no dispute at all upon that point. It is only a question of whether we should give it now, after the pledge that was given to the House of Commons, or deal with it later. I am really surprised after the demand that hon. Members opposite made that they should try to press this now.

The CHAIRMAN

I think I should have pointed out that there are a variety of consequential Amendments that ought to be upon the Paper before this Clause is accepted. I have taken a cursory glance at the Act and there are several paragraphs in the original Act which ought to be repealed in order to make this new Clause in order. That is to say nothing of the three or four other points that are mentioned in the Clause itself. I can rule it out of order now, but I think it would be much better if we had the Clause withdrawn.

Mr. RAMSAY MACDONALD

We moved this Clause because we wanted to get a statement from the Government on the subject. We have got that statement. It is not quite so satisfactory as we should have liked it to be. It is not so satisfactory as my hon. Friends the Irish Members would have liked it to be. But this pledge apparently has been given. I am bound to confess that I knew nothing about it, and that this is the first time I have ever heard of it. But the pledge has been given. Well, we ask leave to withdraw. If that leave is refused, then we shall put our desire to withdraw the Clause into operation in voting, and we shall do it without the least fear or the least shrinking' Medical benefit must be extended to Ireland without any unnecessary delay. If my right hon. Friend says he cannot do it now, and says that this pledge is in existence, and that this Report has not been fully considered, well, I am prepared to say that those two reasons are valid ones, and if the Committee will be good enough to allow us to withdraw, well and good. If the Committee is not good enough to allow us to withdraw, very well, we shall simply take the action which is a necessary consequence of our not being allowed to withdraw.

Mr. LYNCH

I want to say a very few words as representing an agricultural constituency in Ireland. I should be compelled on the general motive of this Clause to vote against it, and I think on the whole the Members representing agricultural constituencies in Ireland, who are in the great majority, would feel that the wisest course would be to have the Clause withdrawn, so that they could in a better manner subsequently deal with the whole question in all its details.

Mr. GWYNNE

The hon. Member for Stockton pointed out that if we passed the Clause as it stands on the Paper, we should not be carrying out the recommendations of the Committee, but would include medical benefit for the whole of Ireland, whereas I understand from the hon. Member for West Belfast it would only include medical benefit for the county boroughs. If we include the Clause as it stands, there is nothing to prevent our cutting it down on Report stage, and if we cannot do it now, we should do it then. I think the right hon. Gentleman said fairly enough that he only received the Report either last night or the night before, and he has not had time to consider the responsibilities involved if he accepts it. If we put in this Clause and do not discuss it fairly, we will have it there and we, on this side, will understand that if we require to modify it, the right hon. Gentleman will let Members know what that Report contains. What is the good of having the report made at all if we are not to know what it contains? I am surprised that hon. Members from Ireland are not looking better after the interests of their country, especially the hon. Member for West Belfast. Would he like to see the Report pigeon-holed to some distant date for the want of making and effort now to get this Clause inserted? I should certainly object to the Clause being withdrawn. I think this is a case in which we might say of the Independent Labour party that they keep their Amendments on a string—"first they put them out and then they pull them in."

Mr. RAMSAY MACDONALD

That statement is altogether untrue and unjustifiable.

Mr. GWYNNE

I ask the hon. Member to say what is untrue.

Mr. RAMSAY MACDONALD

It may not be untrue, but it is exceedingly offensive to call it a "puppet on a string."

Mr. GWYNNE

I did not say "a puppet on a string."

The CHAIRMAN

The hon. Member did not make a definite statement to that effect, but it may have appeared pretty clear what he meant.

Mr. RAMSAY MACDONALD

I withdraw the adjective which I applied.

Mr. LARDNER

The hon. Member for Eastbourne has been very impartial in his distribation of criticism to-day, and particularly about my hon. Friend the Member for West Belfast in respect of his not looking after the interests of his constituents. That is another argument for Home Rule, because it shows the difficulty of the medical benefit question in Ireland. The difficulty of this question is at present as great as is the difference between the Highlands and the Lowlands, and if this is carried into effect it would lead to the greatest chaos and overlapping. The hon. Member for Colchester said that if medical benefit were introduced into the labouring districts the contributions would not be increased.

Mr. WORTHINGTON-EVANS

I did not say that.

Mr. LARDNER

We are now talking about the rural districts. If medical benefits were introduced to-morrow into the rural districts in Ireland, the labourer would get the same service from the same doctor to whom at the present moment he objects. I respectfully submit that, having regard to the statement made by the Financial

Division No. 14.] AYES.
Baker, Sir Randolf Gwynne, Mr. Rupert Newton, Mr.
Boyle, Mr. William Hall, Mr. Frederick (Dulwich) Rolleston, Sir John
Cassel, Mr. Mamilton, Mr. Tryon, Captain
Craik, Sir Henry Lawson, Mr. H. Wolmer, Viscount
Forster, Mr. Locker-Lampson, Mr. Godfrey Worthington-Evans, Mr.
Goulding, Mr. Magnus, Sir Philip
NOES.
Addison, Dr. Dickinson, Mr. Lynch, Mr.
Ainsworth, Mr. Esmonde, Dr. Macnamara, Dr.
Alden, Mr. Gwynn, Mr. Stephen Masterman, Mr.
Beck, Mr. Harcourt, Mr. Robert Millar, Mr.
Booth, Mr. Harvey, Mr. Edmund Pearce, Mr. William
Boyle, Mr. Daniel Jones, Mr. Glyn- Roberts, Mr. Charles
Carr-Gomm, Mr. Jones, Mr. Haydn Samuel, Mr. Jonathan
Cawley, Sir Frederick Keating, Mr. Scott, Mr. MacCallum
Dawes, Mr. Lardner, Mr. Wing, Mr.
Devlin, Mr.